左心室壁中层缩短率评价2型糖尿病患者早期左心室收缩功能变化

摘要

目的:运用左心室壁中层缩短率评价2型糖尿病患者早期左心室收缩功能改变.方法:51例2型糖尿病者(糖尿病组)及30例体验正常者(对照组),行常规及组织多普勒超声心动图检查,测量左心室壁中层缩短率(mFS),计算左心室经线及圆周收缩末期应力,对两组间左心室结构和收缩功能指标即mFS、左心室射血分数、左心室短轴缩短率(LVFS)和二尖瓣环收缩期峰值运动速度(Sm)进行比较,并对mFS与左心室结构参数、空腹血糖水平行相关分析.结果:糖尿病组与对照组比较,左心室舒张末径、左心室收缩末径、左心室质量、左心室心肌质量指数均增加(P<0.01),mFS减低[(21.9±3.4)% vs (24.2±2.6)%,P<0.01].两组间舒张期室间隔厚度、舒张期左心室后壁厚度及相对室壁厚度比较,差异无统计学意义.mFS与左心室收缩末径、左心室质量、左心室心肌质量指数负相关(r 值分别为-0.586、-0.332和-0.239,P<0.05),与空腹血糖水平亦呈负相关 (r =-0.315,P=0.011),这种负相关在校正了年龄、性别、收缩压和体重指数的影响后仍然存在.结论:2型糖尿病患者存在亚临床的左心室收缩功能变化,室壁中层缩短率是检测糖尿病患者早期心肌收缩力下降的敏感指标.%Objective To assess the early changes of left ventricular systolic function by ventricularmidwall fractional shortening( mFS) in patientswith type2 diabetesmellitus( DM).Methods:Our study included two groups, DM group, n = 51 and Control group, n = 30 volunteers without DM Echocardio-graphy was perfomed in all participants to detectmFS, to calculate left ventricular circunferential end-systolic stress and to can-pare left ventricular ejection fraction( LVEF) , left ventricular fractional shortenhg( LVFS), andmitral annular systolic vebcity ( Sm) between two groups In addition, the correlations betweenmFS and the paraneters of cardiac structure and fasting blood glu cose ( FBG) level were analyzedResults: Conpared with Control group, DM group had increased diameter of left ventricle, increased left ventricular mass ( LVM) and leftventricularmass hdex( LVM 1) ,P<0. 01 respectively DM group had lowermFS than that in Control groups 21. 9 ±3. 4)% vs (24. 2±2. 6)% ,P<0. 01. There was no statistic difference for the relative thickness of ventricular wall be ween wo groups mFS was negatively correlated to left ventricular end-systolic diameter, LVM and LVMI( r=-0. 586, r= -0. 332 and r=-0. 239,P<0.05 respectively). mFS was negatively related to FBG ( r =-0. 315, P = 0.011). W ith the adjusted influence of age, gender; systolic blood pressure and body mass index, those negative correlations were still existConclusion: Type2 DM patients have sub-clinical left ventricular systolic functional changes, mFS is a sensitive paraneter for assessing the early ventricular systolic dysfunction in DM patients